Near Miss & Hazard Recognition Form

Alban CAT is a safety first driven company, it is one of our core values. We are dedicated to meeting the goal of ensuring that our employees have the safest working environments possible. In order to meet that goal we need everyone’s help to identify the unsafe conditions that exist in our stores and on the jobsites we work on.

This page was created to give all employees a way to report hazards and near misses. A hazard is an unsafe condition and a near miss is a hazard + an incident that did not result in injury, illness, or damage – but had the potential to do so. Examples: An air hose laying on the floor in a high foot traffic area is a tripping hazard. If someone were to trip on that hose but they did not get injured, that is a near miss.

Thank you for visiting this page and for taking your time to report an unsafe condition. We would like you to give your name and location so we can follow up with you on the report. That information is optional if you wish to remain anonymous. We would also like to know how you would solve the problem.

Name

Division

Location

Near Miss & Hazard Recognition - let us know what happened so we can fix the issue: